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Objectives: This study examined the combined effect of therapist Facilitative Interpersonal Skills (FIS) and Training Status on experiential processes within therapy sessions. In this randomized trial of FIS and Training Status, we predicted that in-session experiential processes would be highest for the high FIS and trained therapist group and lowest for the low FIS and untrained therapists. Methods: Forty-five clients were selected from 2,713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists were selected for their level of FIS (high vs. low) and Training (trainee vs. untrained) and each were assigned two clients for seven sessions each. Two different coder teams independently rated experiencing and narrative process from the third therapy session and computer analysis identified affect words from transcripts. Results: FIS×Training Status significantly interacted on the set of experiential process measures. Relative to all others, therapists who were in the low FIS / no training group had lower experiencing and reflexive content, but higher external content. Conclusions: The findings highlight the importance of therapist characteristics within therapy sessions. Therapists without training and with low interpersonal skills have sessions that are nearly devoid of content that focuses on client experiential processes and emotion.

Objective: In a secondary analysis of Friedlander et al.'s [(2018). “If those tears could talk, what would they say?” multi-method analysis of a corrective experience in brief dynamic therapy. Psyc...

Goals Securing clients' active and enthusiastic collaboration to participate in activities therapists would like to implement in therapy (e.g., free association, in vivo exposure, or the engagement in chair work) is a core mission in therapy. However, from the clients' perspective, these tasks frequently represent novel challenges that can trigger anxiety and reluctance. Thus, a key element in therapy is the negotiation between therapist and client to move beyond such reluctance to potentially effective therapy activities and, at the same time, maintain positive relational affiliation between therapist and client. In this research we examined (1) a collection of therapist proposal/client response sequences that were geared toward recruiting participation in chair work and (2) sequences containing hesitation or instances where decisions to engage in chair work were deferred and related relational disaffiliation. Our goal was to identify the conversational resources (both verbal and non-verbal) that worked to reject a proposed activity (or convey impending rejection) and examine the interactional practices directed at resolving client reluctance. Method We used the conceptual and methodological resources of Conversation Analysis to examine a corpus of proposal/response sequences that targeted chair work entry in Emotion-focused Therapy. Results The resulting data set included some smooth and successful engagements and others more challenging, involving clients delaying or resisting engagement with chair work. Clients were found to defer or refuse engagement through a range of resources such as withholding a response (silence), questioning the authenticity of the task, or directly refusing. We identified specific therapist practices that facilitated engagement in "refusal-implicative" contexts such as proffering "or" alternatives, offering extended rationales for the activity (accounting), and elaborating on the proposals. We observed that the therapists' deontic stance (mitigated and reduced claims to authority) and moderated epistemic positioning (deference to the client's primacy of knowledge and information) played an important role in facilitating engagement. Conclusion Our research highlights the kinds of interactional sequences in which clients and therapists are able to achieve alignment in mutually working toward chair work entry. Based on these observations, we offer some practical advice to therapists in formulating proposals to engage clients during in-therapy work.

In this chapter, the case is made that the procedure for memory reconsolidation (MR) is compatible with the strategies and interventions of modern psychodynamic psychotherapy. In particular the concept of the corrective emotional experience (CEE) is seen as integral to the MR process. A measure (the Narrative-Emotional Processing Coding System [NEPCS]) was used to code transcripts from a case being seen in Time-Limited Dynamic Psychotherapy. Results indicate that the NEPCS was able to track key shifts consistent with the MR process and CEE. One implication of this work is that psychodynamic therapists might be able to use an MR framework intentionally to foster enduring change more effectively and efficiently.

According to a narrative-emotion informed psychotherapy approach, individuals enter psychotherapy when their narratives lack flexibility and emotional coherence. Effective psychotherapy helps clien...

This paper examines the interactional accomplishment of chair work, which is one type of therapeutic intervention for exploring client emotions in Emotion Focused Therapy (EFT). During this intervention, therapists guide clients to speak with either a conflicted aspect of self (two-chair work) or with a non-present significant other to address unresolved feelings or ‘unfinished business’ (empty-chair work). Using the methods of conversation analysis, we examine ten video-taped EFT sessions that incorporate chair work. It was found that chair work entry is regularly accomplished through four distinct interlocking interactional phases: 1) Formulating the client's trouble; 2) Recruiting participation in chair work; 3) Readjusting the participation frame; 4) Making contact. We will show how each phase orients to specific interactional concerns that often pertain to managing epistemic and/or deontic authority and also to accommodating the participants into entering a new participation frame. Although gaining client confirmation and compliance was at times promptly achieved within these phases, clients also regularly delayed their affiliative uptake of the therapist's prior action. We will show, in these cases, how therapists perform additional interactional work to get chair work entry back on track.

Despite the importance of narrative, emotional and meaning-making processes in psychotherapy, there has been no review of studies using the main instruments developed to address these processes. The objective is to review the studies about client narrative and narrative-emotional processes in psychotherapy that used the Narrative Process Coding System or the Narrative-Emotion Process Coding System (1.0 and 2.0). To identify the studies, we searched The Book Collection, PsycINFO, PsycARTICLES, PsycBOOKS, PEP Archive, Psychology and Behavioral Sciences Collection, Academic Search Complete and the Web of Knowledge databases. We found 27 empirical studies using one of the three coding systems. The studies applied the Narrative Process Coding System and the Narrative-Emotion Process Coding System to different therapeutic modalities and patients with various clinical disorders. In some studies, early, middle and late phases of therapy were compared, while other studies conducted intensive case analyses of Narrative Process Coding System and Narrative-Emotion Process Coding System patterns comparing recovered vs unchanged clients. The review supports the importance to look for the contribution of narrative, emotion, meaning-making patterns or narrative-emotion markers, to treatment outcomes and encourages the application of these instruments in process-outcome research in psychotherapy.

We explored the interactive process in which therapists respond to client self-critical positions.Drawing from the resources of conversation analysis (CA), we examined a corpus of in-session self-critical sequences of talk occurring in different kinds of treatments: Client Centered Therapy, (CCT), Emotion Focused Therapy (EFT), Psychoanalytic Psychotherapy (PP) and in different cultural contexts.It was found that client self-critical talk performed various functions pertaining to diminished control, accountability (e.g., failed obligations leading to self-blame) and disparaging evaluations of self (contempt or disgust). Further, therapists were found to respond in ways that targeted the client's report of having diminished control or of being accountable for their negative attributes by providing a more optimistic reading of the client's experience, one that is more open to positive outcomes and the possibility of change. Our sequential analysis not only shows how clients may resist these optimistic readings, but also how therapists work towards successfully achieving moments of re-affiliation.We anticipate that the fine-grained sequential analysis of therapy interaction can provide therapists with a more detailed understanding of the options and challenges therapists face when working with clinical challenges of clients' self-critical positions.

A corrective experience (CE) is one "in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided.

Although the concept of corrective experiences (CEs) is usually linked to the process of change in psychotherapy patients, we investigated them in the professional development of therapists-in-training. Inasmuch as psychotherapy is a relational process, it is important to look closely at how therapists reach the position of a competent partner in corrective experiencing. In this study, we interviewed 10 therapists-in-training undergoing their own training therapy. Responses to these semistructured interviews were analyzed using a computer-assisted grounded theory method. The 499 first-level categories were grouped into 5 main themes: therapist characteristics, therapist technical interventions, therapist relational interventions, relationship experience, and outcome experience. Two core categories representing corrective experiencing were (a) unexpected unconditional support from and trust in their own therapist and (b) unexpected confrontation and limitation with their therapist as well as awareness of self-other boundaries. Results are discussed in the broader context of the CE literature, relational theory, and relational practice.

The Patient Perceptions of Corrective Experiences in Individual Therapy (PPCEIT; Constantino, Angus, Friedlander, Messer, & Moertl, 2011) posttreatment interview guide was developed to provide clinical researchers with an effective mode of inquiry to identify and further explore clients' firsthand accounts of corrective and transformative therapy experiences and their determinants. Not only do findings from the analysis of client corrective experience (CE) accounts help identify what and how CEs happen in or as a result of psychotherapy, but the measure itself may also provide therapists with an effective tool to further enhance clients' awareness, understanding, and integration of transformative change experiences. Accordingly, we discuss in this afterword to the series the implications for clinical practice arising from (a) the thematic analysis of client CE accounts, drawn from a range of clinical samples and international research programs and (b) the clinical effect of completing the PPCEIT posttreatment interview inquiry. We also identify directions for future clinical training and research.

This article introduces a series of 4 original research reports that used varied qualitative methods for understanding an internationally diverse sample of clients’ own accounts of corrective experiences (CEs), as they looked back on their completed psychotherapy. The basis for all studies, which were conducted across 4 different countries, was the Patients’ Perceptions of Corrective Experiences in Individual Therapy (PPCEIT) semistructured interview protocol (Constantino, Angus, Friedlander, Messer, & Moertl, 2011). The PPCEIT interview assesses clients’ retrospective accounts of aspects of self, other, and/or relationships that may have been corrected, and what they perceived as corrective experiences that facilitated such transformations. It also asks for specific, detailed examples of these accounts and experiences. Across all studies, the PPCEIT interview generated rich clinical material and resulting empirically generated themes that may inform clinical practice. After briefly defining the CE construct and highlighting a lack of research on clients’ own accounts of such experiences, we describe the development of the PPCEIT interview (and provide the full interview manual and question protocol as appendices). We then summarize the foci of the culturally diverse reports in this series.

Corrective experiences (CEs), which suggest transformative experience(s) for the psychotherapy patient, have a rich theoretical history; yet there is little empirical information on patients’ own perceptions of what gets “corrected” from therapy, and what is “corrective” (i.e., the mechanisms driving the CE). To address this gap, we investigated 14 patients’ posttreatment accounts of both CE elements in the context of naturalistically delivered individual psychotherapy, using a consensual qualitative research methodology. Extending prior research focused on patients’ accounts of CEs while still engaged in treatment (Heatherington et al., 2012), the present results revealed that patients retrospectively identified an array of categories that were deemed corrected, such as positive changes in cognitions, interpersonal problems, self-concepts, symptoms, and behaviors. Patients also identified CEs that may have led to those shifts/transformations, including their therapist's actions (especially giving feedback), their own agentic actions (especially engaging in the therapeutic process), and the patient–therapist collaborative and engaged relationship. Clinical practice implications are discussed.

We analyzed master theorist/therapist Hanna Levenson's six-session work with "Ann" in American Psychological Association's Theories of Psychotherapy video series to determine if and how this client had a corrective experience in Brief Dynamic Therapy. First, we identified indicators of a corrective experience in the therapist's and client's own words. Complementing this analysis, we used observational coding to identify, moment by moment, narrative-emotion markers of shifts in Ann's "same old story"; the frequency, type, and depth of immediacy; and the client's and therapist's behavioral contributions to the working alliance. Additionally, we qualitatively analyzed Levenson's session-by-session accounts of the therapy from two sources. Convergent evidence from these multi-method analyses suggested how the intertwined relational and technical change processes seemed to bring about this client's corrective experience. Through consistent attention to the alliance and increasingly deep immediacy, Levenson created a safe space for Ann to "bring down the wall"-by allowing herself to cry and be deeply understood and cared for in a way that she had never before experienced. Concurrently, Ann began seeing herself quite differently, signified by self-identity narrative change. Then, following Session 4, she took Levenson's suggestion to risk behaving more authentically with a friend and with her romantic partner.

Objective: This research explored the consolidation phase of emotion-focused therapy (EFT) for depression and studies—through a task-analysis method—how client–therapist dyads evolved from the exploration of the problem to self-narrative reconstruction. Method: Innovative moments (IMs) were used to situate the process of self-narrative reconstruction within sessions, particularly through reconceptualization and performing change IMs. We contrasted the observation of these occurrences with a rational model of self-narrative reconstruction, previously built. Results: This study presents the rational model and the revised rational-empirical model of the self-narrative reconstruction task in three EFT dyads, suggesting nine steps necessary for task resolution: (1) Explicit recognition of differences in the present and steps in the path of change; (2) Development of a meta-perspective contrast between present self and past self; (3) Amplification of contrast in the self; (4) A positive appreciation of changes is conveyed; (5) Occurrence of feelings of empowerment, competence, and mastery; (6) Reference to difficulties still present; (7) Emphasis on the loss of centrality of the problem; (8) Perception of change as a gradual, developing process; and (9) Reference to projects, experiences of change, or elaboration of new plans. Conclusions: Central aspects of therapist activity in facilitating the client's progression along these nine steps are also elaborated, tuguese Foun- dation for Science and Technology [grant PTDC/PSI-PCL/121525/2010] (Ambivalence and unsuccessful psychotherapy, 2007–2010) and by the Ph.D. grant [SFRH/BD/30880/2006]

The Narrative-Emotion Process Coding System (NEPCS) is a behavioral coding system that identifies eight client markers: Abstract Story, Empty Story, Unstoried Emotion, Inchoate Story, Same Old Story, Competing Plotlines Story, Unexpected Outcome Story, and Discovery Story. Each marker varies in the degree to which specific narrative and emotion process indicators are represented in one-minute time segments drawn from videotaped therapy sessions. As enhanced integration of narrative and emotional expression has previously been associated with recovery from complex trauma, the purpose of the present pilot study was to examine the contribution of within session NEPCS markers to treatment outcomes for clients undergoing Emotion-Focused Therapy for Trauma (EFTT). The NEPCS was applied to two early, two middle, and two late videotaped therapy sessions selected from two recovered and two unchanged complex trauma EFTT clients. Exploratory statistical analyses established that unchanged clients expressed s...

This chapter describes the quantitative research findings from an intensive analysis of metaphor use in good-outcome and poor-outcome Brief Dynamic therapy dyads is presented first. It explores the interface between metaphor use and the emergence of themes, the returns from an intensive qualitative analysis of one good-outcome Brief Dynamic therapy dyad is reported next. The chapter shows the interrelation between metaphor and the evolution of therapy themes in productive psychotherapy is discussed and suggestions for clinical practice are put forward. For psychotherapy researchers, the selective analysis of recurring metaphor themes may be a particularly productive and meaningful method for tracing both the development of productive working alliances in therapy relationships as well as for tracing the specific conceptual and experiential stages entailed in the successful resolution of longstanding interpersonal problems.

Qualitative data acquired within the recent Czech part of the independent, multi-site collaborative research project Corrective Experiences are the core basis of this paper. Eight post-treatment interviews with clients of individual therapies were analysed with a special focus on the role of cultural beliefs and cultural expectations in the clients’ change of interpersonal attitudes. The methodology of this research is based on in-depth interviews providing data on significant shifts or changes in attitudes toward relationships after the end of therapy. All clients completed their therapeutic treatments prior to the interviews. We monitored the experiences of our participants in the following significant domains: first, how they perceive the aspect of the self and others, including relationships that had been modified, and second, what they perceive as corrective experiences within as well as outside of therapy and in interactions with others. These data were then analysed within the Czech cultural contex...

Objective: Over the past 25 years, humanistic psychotherapy (HP) researchers have actively contributed to the development and implementation of innovative practice-informed research measures and coding systems. Method: Qualitative and quantitative research findings, including meta-analyses, support the identification of HP approaches as evidence-based treatments for a variety of psychological conditions. Results: Implications for future psychotherapy research, training, and practice are discussed in terms of addressing the persistent disjunction between significant HP research productivity and relatively low support for HP approaches in university-based clinical training programs, funding agencies, and government-supported clinical guidelines. Conclusion: Finally, specific recommendations are provided to further enhance and expand the impact of HP research for clinical training programs and the development of treatment guidelines.

Within emotion-focused therapy (EFT), the client’s ability to express and reflect on core emotional experiences is seen as fundamental to constructing the self and to entering into a change process. For this study, we 1) examine storytelling contexts in which clients do not disclose the emotional impact of their narrative, and 2) identify the interactional practices through which EFT therapists subsequently call attention to what the client may have felt. In doing so, we examine client stories drawn from video-taped individual psychotherapy sessions involving clinically depressed clients. Client stories and therapists’ responses to these stories were analysed using conversation analytic methods. Three different therapist response types were identified: eliciting, naming and illustrating the emotional impact of the client’s prior narrative. These responses also were found to differ in terms of how effectively they could display empathy and secure affiliation with clients. The implications of this work for therapeutic practice are discussed.

Objective: Ambivalence can be understood as a cyclical movement between an emerging narrative novelty—an Innovative Moment (IM)—and a return to a problematically dominant self-narrative. The return implies that the IM, with its potential for change is devalued right after its emergence. Our goal is to test the hypothesis that the probability of the client expressing such form of ambivalence decreases across treatment in good-outcome cases but not in poor-outcome cases. Method: Return-to-the-Problem Markers (RPMs) signaling moments of devaluation of IMs were coded in passages containing IMs in six clients with major depression treated with emotion-focused therapy: three good-outcome cases and three poor-outcome cases. Results: The percentage of IMs with RPMs decreased across therapy in good-outcome cases, whereas it remained unchanged and high in the poor-outcome cases. Conclusions: These results were consistent with the theoretical suggestion that therapeutic failure may be associated with this form of ambivalence., Obiettivo: L'ambivalenza può essere considerata come un movimento ciclico tra un nuovo elemento narrativo emergente - Innovative Moment (IM) - e il ritorno ad una auto-narrazione problematica dominante. Il ritorno implica che il IM perde il proprio potenziale di favorire un cambiamento nel momento in cui emerge. Il nostro obiettivo è quello di verificare l'ipotesi che la probabilità che il paziente possa esprimere tale forma di ambivalenza diminuisce nel corso di un trattamento che ha un buon esito, ma non nei casi con esito negativo. Metodo: in sei pazienti affetti da depressione maggiore trattati con terapia focalizzata sulle emozioni, sono stati codificati i passaggi contenenti IM utilizzando il Return-to-the-Problem Markers (RPMs) che segnala i passaggi in cui IM vengono svalutati: tre casi con buon esito e tre con esito negativo. Risultati: La percentuale di IM con gli RPM diminuiva nel corso delle terapie dei casi con buon esito, mentre è rimasto invariato ed elevato nei casi con scarso esito. Conclusioni: Questi risultati sono coerenti con il presupposto teorico che il fallimento terapeutico possa essere associato a questa forma di ambivalenza., Objetivo: A ambivalência pode ser entendida como um movimento cíclico entre uma novidade narrativa emergente – um Momento de Inovação (MI) – e um retorno à narrativa problemática dominante. O retorno implica que o MI, com o seu potencial para a mudança, seja desvalorizado logo após a sua emergência. O nosso objetivo é testar a hipótese de que a probabilidade do cliente expressar tal forma de ambivalência diminui ao longo do tratamento em casos de sucesso mas não em casos de insucesso terapêutico. Método: Marcadores de Retorno ao Problema (MRP) que assinalam momentos de desvalorização dos MIs foram codificados em passagens contendo MIs em seis casos de clientes com depressão major tratados com terapia focada nas emoções: três casos de sucesso e três casos de insucesso. Conclusões: Estes resultados foram consistentes com as sugestões teóricas de que o insucesso terapêutico poderá estar associado a esta forma de ambivalência., Ziel: Ambivalenz kann als zyklische Bewegung zwischen einer emergenten narrativen Neuheit – einem Innovative Moment (IM) – und einer Rückkehr zu einer problematischen dominanten Selbst-Erzählung verstanden werden. Diese Rückkehr impliziert, dass der IM mit seinem Potential für Veränderung direkt nach seinem Auftauchen abgewertet wird. Unser Ziel ist die Hypothese zu testen, dass die Wahrscheinlichkeit, dass der Klient eine solche Form der Ambivalenz zeigt, bei Fällen mit gutem Therapieergebnis über die Behandlung abnimmt, aber nicht in Fällen mit schlechtem Ergebnis. Methode: Rückkehr-zu-dem-Problem Marker (RPMs), die Momente signalisieren, in denen IMs abgewertet werden, wurden in Passagen, die IMs beinhalten, von sechs Klienten mit Major Depression, die mit emotionsfokussierter Therapie behandelt wurden, kodiert: 3 Fälle mit gutem und 3 Fälle mit schlechtem Therapieergebnis. Ergebnisse: Der Prozentsatz von IMs mit RPMs verringerte sich bei Fällen mit gutem Ergebnis über die Therapie hinweg, wohingegen er in den Fällen mit schlechtem Ergebnis unverändert und hoch blieb. Schlussfolgerung: Die Ergebnisse waren mit dem theoretischen Vorschlag konsistent, dass therapeutischer Misserfolg mit dieser Form der Ambivalenz assoziiert ist., 目標：矛盾可以視為是種擺盪在新產生的新穎敘說—創意時刻(IM)—和回復到一種有問題的支配性自我敘說之間的循環動作。回復意味著潛藏改變契機的IM，其價值在出現後即被摒棄。我們的目標是檢視以下假設的可能性：「在具良好成效的案例中，案主在治療歷程中表達這種形式的矛盾會降低；而在不良成效的案例中則否」。方法：在六位具有嚴重憂鬱症患者的IM段落中，找到顯示IM價值降低時刻的故態復萌標記（RPMs）並加以編碼。這六位患者均接受情緒焦點治療，其中三位為具良好成效案例，另外三位為不良成效案例。結果：在具良好成效案例中，IM當中具有RPM的比率降低；而在不良成效的案例中，RPM的比率維持不變或更高。結論：此結果與理論假設一致，即假設治療的失敗可能與這種形式的矛盾有關。

This article examines how Emotion-focused therapists use person-centred relational practices to re-affiliate with clients after clients have disagreed with therapists’ formulations of clients’ personal experience. Using the methods of conversation analysis, 70 client disagreements were identified from 15 video-taped sessions of Emotion-focused psychotherapy. Our main finding is that, in contexts of disagreement, talk is organized in Emotion-focused therapy to (1) maintain affiliation by neutralizing the potential conflict; and (2) preserve the client's epistemic primacy of experience by privileging the client's viewpoint. Person-centred relational practices were realized in two different ways: Most commonly, therapists would retreat from own position by affiliating with the client's contrasting position through a range of non-verbal (nods) and verbal resources (mirroring repeats, joint completions, second formulations); less common was for therapists to confront the disagreement, primarily as a problem in understanding that requires repair. Whereas the practice of retreating would lead to mutual affiliation and consensus between the participants, confronting the disagreement did not always lead to successful re-affiliation. This is because the therapist's repair initiation would sometimes contest the client's viewpoint, thus fostering further disaffiliation and placing the client's epistemic primacy at risk.

[Excerpt] The aim of this special section is to present a review of recent advances in the assessment of changes in client narratives. An emerging trend in the psychotherapy research field suggests that narrative-based meaning reconstruction is an important foundation for the articulation of a new, more adaptive view of self (Angus & Kagan, 2013) in psychotherapy. Additionally, a range of research-informed treatment models, including psychodynamic (Luborsky, 1998), humanistic (Angus, Watson, Elliott, Schneider, & Timulak, 2015) and systemic therapy approaches (Dallos & Vetere, 2009), emphasize that client changeinpsychotherapyisfacilitatedthroughpersonal story disclosure, emotional engagement and reflection for new meaning construction and self-narrative reorganization. In fact, recent research from Angus et al. (inpress)andGonçalvesetal.(thisissue),usingdifferent methods and clinical samples, have independently established that successful psychotherapy involves client self-narrative transformation processes evidenced in late phase therapy sessions. (...)

Personality researchers use the term self-narrative to refer to the development of an overall life story that places life events in a temporal sequence and organizes them in accordance to overarching themes. In turn, it is often the case that clients seek out psychotherapy when they can no longer make sense of their life experiences, as a coherent story. Angus and Greenberg (L. Angus and L. Greenberg, 2011, Working with narrative in emotion-focused therapy: Changing stories, healing lives. Washington, DC: American Psychological Association Press) view the articulation and consolidation of an emotionally integrated self-narrative account as an important part of the therapeutic change process that is essential for sustained change in emotion-focused therapy of depression. The purpose of the present study was to investigate client experiences of change, and self-narrative reconstruction, in the context of one good outcome emotion-focused therapy dyad drawn from the York II Depression Study. Using the Narrative Assessment Interview (NAI) method, client view of self and experiences of change were assessed at three points in time--after session one, at therapy termination, and at 6 months follow-up. Findings emerging from an intensive narrative theme analyses of the NAI transcripts--and 1 key therapy session identified by the client--are reported and evidence for the contributions of narrative and emotion processes to self-narrative change in emotion-focused therapy of depression are discussed. Finally, the implications of assessing clients' experiences of self-narrative change for psychotherapy research and practice are addressed.

Although the concept of corrective experiences (CEs) is usually linked to the process of change in psychotherapy patients, we investigated them in the professional development of therapists-in-training. Inasmuch as psychotherapy is a relational process, it is important to look closely at how therapists reach the position of a competent partner in corrective experiencing. In this study, we interviewed 10 therapists-in-training undergoing their own training therapy. Responses to these semistructured interviews were analyzed using a computer-assisted grounded theory method. The 499 first-level categories were grouped into 5 main themes: therapist characteristics, therapist technical interventions, therapist relational interventions, relationship experience, and outcome experience. Two core categories representing corrective experiencing were (a) unexpected unconditional support from and trust in their own therapist and (b) unexpected confrontation and limitation with their therapist as well as awareness of self-other boundaries. Results are discussed in the broader context of the CE literature, relational theory, and relational practice.

Corrective experiences (CEs), which suggest transformative experience(s) for the psychotherapy patient, have a rich theoretical history; yet there is little empirical information on patients' own perceptions of what gets "corrected" from therapy, and what is "corrective" (i.e., the mechanisms driving the CE). To address this gap, we investigated 14 patients' posttreatment accounts of both CE elements in the context of naturalistically delivered individual psychotherapy, using a consensual qualitative research methodology. Extending prior research focused on patients' accounts of CEs while still engaged in treatment (Heatherington et al., 2012), the present results revealed that patients retrospectively identified an array of categories that were deemed corrected, such as positive changes in cognitions, interpersonal problems, self-concepts, symptoms, and behaviors. Patients also identified CEs that may have led to those shifts/transformations, including their therapist's actions (especially giving feedback), their own agentic actions (especially engaging in the therapeutic process), and the patient-therapist collaborative and engaged relationship. Clinical practice implications are discussed.

Recent studies suggest that it is not simply the expression of emotion or emotional arousal in session that is important, but rather it is the reflective processing of emergent, adaptive emotions, arising in the context of personal storytelling and/or Emotion-Focused Therapy (EFT) interventions, that is associated with change.To enhance narrative-emotion integration specifically in EFT, Angus and Greenberg originally identified a set of eight clinically derived narrative-emotion integration markers were originally identified for the implementation of process-guiding therapeutic responses. Further evaluation and testing by the Angus Narrative-Emotion Marker Lab resulted in the identification of 10 empirically validated Narrative-Emotion Process (N-EP) markers that are included in the Narrative-Emotion Process Coding System Version 2.0 (NEPCS 2.0).Based on empirical research findings, individual markers are clustered into Problem (e.g., stuckness in repetitive story patterns, over-controlled or dysregulated emotion, lack of reflectivity), Transition (e.g., reflective, access to adaptive emotions and new emotional plotlines, heightened narrative and emotion integration), and Change (e.g., new story outcomes and self-narrative discovery, and co-construction and re-conceptualization) subgroups. To date, research using the NEPCS 2.0 has investigated the proportion and pattern of narrative-emotion markers in Emotion-Focused, Client-Centered, and Cognitive Therapy for Major Depression, Motivational Interviewing plus Cognitive Behavioral Therapy for Generalized Anxiety Disorder, and EFT for Complex Trauma. Results have consistently identified significantly higher proportions of N-EP Transition and Change markers, and productive shifts, in mid- and late phase sessions, for clients who achieved recovery by treatment termination.Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative change. Implications for future research, practice and training are discussed.

This study aimed to further understand how narrative flexibility contributes to therapeutic outcome in brief psychotherapy for depression utilizing the Narrative-Emotion Process Coding System (NEPCS), an observational measure that identifies specific markers of narrative and emotion integration in therapy sessions.The present study investigated narrative flexibility by examining the contribution of NEPCS shifting (i.e., movement between NEPCS markers) in early, middle, and late sessions of client-centred therapy (CCT), emotion-focused therapy (EFT), and cognitive therapy (CT) and treatment outcome (recovered versus unchanged at the therapy termination). A logistic regression, with Wald tests of parameter estimates and pairwise comparisons, was used to test the study hypotheses.Results demonstrated that for recovered clients, the probability of shifting over the course of a therapy session was constant, whereas the probability of shifting declined for unchanged clients as the session progressed. There was also evidence that longer duration of time spent in any single NEPCS marker was negatively associated with shifting for both recovered and unchanged clients, although the effect was stronger for unchanged clients.The results provided preliminary support for the contribution of narrative flexibility to treatment outcomes in EFT, CCT, and CT treatments of depression.

The focus of this article is the increasingly narrow range of therapeutic orientations represented in clinical psychology graduate training programs, particularly within the most research-oriented programs. Data on the self-reported therapeutic orientations of faculty at “clinical science” Ph.D. programs, Ph.D. programs at comprehensive universities in clinical and in counseling psychology, Psy.D. programs at comprehensive universities, and Ph.D. or Psy.D. programs at freestanding specialized institutions reveal a strong predominance of faculty with cognitive-behavioral orientations at the more science-focused programs, and a narrower range of orientations than in the more practice-focused programs. We discuss the implications of this trend for the future development of clinical psychology and provide suggestions for addressing the attendant concerns.